Question

A 70-year-old man with suspected sepsis from pneumonia is hypotensive at 82/50 mmHg with a lactate of 4 mmol/L. He has no known heart failure and appears peripherally cool with prolonged capillary refill. According to NICE and UK Sepsis Trust guidance, what is the most appropriate initial intravenous fluid strategy?

Accepted Answer

Give 500 mL of crystalloid over less than 15 minutes and reassess, repeating boluses as needed up to around 20 mL/kg.

Answer

Start a maintenance infusion of 0.9% sodium chloride at 80 mL/hour and reassess in 6 hours.

Answer

Give 1 L of 5% dextrose over 1 hour as first-line resuscitation fluid.

Answer

Avoid fluids initially and start vasopressors immediately.

Answer

Restrict fluids to 250 mL over 4 hours to avoid pulmonary oedema.

Practice question